Bladder Ca

Question 1

Give the types of bladder cancer tumours

Answer 1

Epithelial - TCC, Squamous cell carcinoma (schistosomiasis), Adenocarcinoma

Connective tissue tumours- Rhabdomyosarcoma, Leiomyosarcoma (all rare)

Question 2

List the risk factors for bladder cancer

Answer 2

Smoking
Industrial carcinogens
Drugs
Pelvic radiation
Urinary tract diseases eg schistosomiasis

Question 3

Outline the staging of bladder ca

Answer 3

1. Non muscle invasive
   -CIS (highly malignant, potential for invasion and metastasis)
   -Papillary (good prognosis)
2. Muscle invasive
3. Metastatic

T staging
Localised - Tis, Ta, T1
Muscle invasive - T2a, T2b
Locally advanced disease - T3 and T4

Question 4

List the clinical presentation of bladder cancer

Answer 4

Painless macro Haematuria
Micro Haematuria l
Irritation voiding symptoms
Suprapubic pain or lower abdo mass
Metastasis symptoms

Question 5

List some of the causes if filling defect in bladder

Answer 5

Tumour
Blood clot
Stones
Prostate
Volley catheter balloon
Overlying bowel gas
Foreign object

Question 6

Discuss management of bladder ca

Answer 6

(According to stages)

CIS -BCG (Bacillus Calmette Guerin) weekly then every 3 months*3yrs or radical cystectomy if unsuccessful

T1/ papillary lesion - TURB, then cystectescopy every 3months
-chemo, mitomycin or BCG if recurrent tumours
- cystectomy if extensive multiple tumours

T2-T3 Radical cystectomy
Radical radiotherapy if surgical refusal
-post op chemo

T4 - palliative

Question 7

What tx do you give to pt with severe irritation bladder cancer symptoms

Answer 7

Anticholinergic, urinary diversion